21. Safe drinking
Matter for discussion submitted by the RCN Health Visitors and Public Health Forum
That this meeting of RCN Congress discusses the nurse’s role in promoting safe and responsible alcohol use
Report on this debate
The RCN Health Visitors and Public Health Forum led a discussion on the final day of Congress on how nurses can play a part in the promotion of safe and responsible alcohol use.
Linda Bailey from the RCN Health Visitors and Public Health Forum began the discussion by saying that every nurse has a vital role to play in combating the harm caused by alcohol abuse. She said, ‘Don’t let alcohol misuse be thought of as some one else’s problem.’
Linda urged delegates to take the first step to raise the issue with patients, to be aware of what constitutes safe alcohol use and remember that prevention is always better than cure.
Sue Howarth said that partnership working is key to the successful promotion of safe and responsible alcohol use. Sue said that nurses need to share their knowledge and reach out to the community. She added that nurses need to start to empower people to change their lives and make better choices.
Andy McGovern argued that when looking at this issue the role of governments and licensees also needs to be examined. He said that the legal drinking age should be challenged along with the availability and promotion of alcohol.
Background
The World Health Organization’s estimations of adult alcohol consumption puts the UK in the top 30 positions of adult per capital alcohol consumption rankings (placed 22 out of 185 countries) (WHO, 2005). The effects of alcohol misuse are well documented and include health problems, harm to others (for example, domestic violence and child abuse), crime and disorder, assault, and social nuisance.
The Department of Health estimates that alcohol-related problems cost the NHS in England approximately £1.6 billion per year, while the wider costs to society are around £20 billion. Around 35 per cent of all A&E attendances are thought to be linked to alcohol, at a cost of £0.5 billion per annum (Prime Minister’s Strategy Unit, 2003).
Opinion surveys suggest that alcohol is now a major cause of concern to the UK public. All four UK governments have acknowledged the rising prevalence of alcohol consumption. Rates of binge drinking are growing; for example from a reported 19 per cent of adults in Wales to 48 per cent male and 35 per cent female rates in Northern Ireland., while alcohol use among children and young people is growing faster than any other drug in the UK. National Institute for Health and Clinical Excellence guidance (NICE, 2007) recommends interventions in school to prevent alcohol use, and that school nurses ― as part of multi-professional teams ― should ensure that tailored education is an integral part of school curricula.
The four UK administrations have undertaken needs assessments and produced strategies on alcohol. Common recommendations include cross-departmental action, with multidisciplinary coordinated approaches to prevention and treatment. Nurses are explicitly mentioned as having a role to play in all four country strategies, most notably in Scotland where the 2008 strategy on alcohol misuse will pledge to increase the number of alcohol nurses in acute and primary care settings.
Research evidence demonstrates the effectiveness of brief interventions in primary care such as motivational interviewing, patient-centred counselling, and advice protocols delivered by nurse practitioners, physicians and other primary care practitioners; the appointment of an alcohol liaison nurse in Belfast’s Mater Hospital saved 1,009 bed days ― or £237,115 over one year ― with length of stay reduced from seven to 4.7 days.
The RCN is a member of the recently formed Alcohol Health Alliance UK (2008) which is calling for governments to adopt a twin strategy of increasing tax on alcohol and reducing its ease of availability. Alcohol related harm is a major issue in the UK. Policy recommendations in the four countries consistently emphasise multi-sectoral and multi-professional targeted action. While nursing is explicitly mentioned in all four strategies, the extent to which nurses are actually involved in promoting safe and responsible alcohol use is unknown.
References and further reading
Alcohol Health Alliance UK (2008) Alcohol Health Alliance UK, London: Royal College of Physicians. Available from: www.rcplondon.ac.uk/alcoholalliance (Accessed 4 February) (Internet).
National Institute for Health and Clinical Excellence (2007) Interventions in schools to prevent and reduce alcohol use among children and young people, London: NICE.
Available from: www.nice.org.uk/guidance/index.jsp?action=download&o=38407
(Accessed 4 February) (Internet).
Pearce L (2006) Sobering message, Nursing Standard, 20 (39), pp.20-21.
Prime Minister's Strategy Unit (2003) Alcohol misuse: how much does it cost?, London: Cabinet Office.
World Health Organization (2005) Global Information System on Alcohol and Health: (GISAH), Geneva: WHO. Available from: www.who.int/globalatlas
(Accessed 4 February) (Internet).